- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.02 / $11,611.47 / $24,068.03
| Facility | | $5,417.02 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,065.60 / $6,609.33 / $12,887.71
| Facility | | $5,065.60 | $6,609.33 | $12,887.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,572.30 / $16,572.30 / $16,572.30
| Facility | | $16,572.30 | $16,572.30 | $16,572.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.23 / $2,961.38 / $23,805.09
| Facility | | $1,314.23 | $2,961.38 | $23,805.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,932.00 / $3,623.36 / $22,602.68
| Facility | | $1,932.00 | $3,623.36 | $22,602.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $9,496.00 / $13,068.65
| Facility | | $6,777.00 | $9,496.00 | $13,068.65 |